Aneurysm of the pulmonary artery with cystic medial necrosis and massive pulmonary valvular insufficiency. Report of two successful surgical cases.

The authors report two cases of true aneurysms of the pulmonary artery (APA) associated with massive pulmonary valvular insufficiency. Both were associated with pulmonary artery hypertension and showed cystic medial necrosis at microscopic examination. One case had no associated defects while the other had a large ventricular septal defect and a small patent ductus arteriosus. Both were treated by aneurysmorrhaphy and a valvular procedure (valve replacement, valvuloplasty). The clinical results were excellent. Catheterization at 2 years showed no further aneurysm formation, no pulmonary hypertension, and mild pulmonary valve insufficiency in both patients. The literature concerning APA is reviewed and the etiology and the surgical treatment of APA discussed. A unique method of treating pulmonary valve insufficiency is reported.